ISSN0535-1405

No. 506

July 31, 2021
Published by International Medical Society of Japan,Chairman, Board of Directors: Kenichi Ishibashi, MD, PhD
Editors: K. Ito, MD, PhD, T. Kondo, MD, PhD,K. Ichihashi, MD, PhD, T. Murakami, PhD, R.Nagai, MD, PhD,
I. Taniguchi, MD, PhD, and T. Yamazaki, MD, PhD
3F MK Sangenjaya Building, 1-15-3 Kamiuma, Setagaya-ku,Tokyo154-0011,Japan.
TEL 03(5486)0601 FAX 03(5486)0599 E-mail: imsj@imsj.or.jp https://www.imsj.or.jp/

The 449th International Symposium on Therapy
The 449th International Symposium on Therapy washeld by the Zoom Webinar on May 27, 2021. Dr. Taro
Kondo, Managing Director of the International
Medical Society of Japan (IMSJ), presided over themeeting.

Utilization of ICT and AI in healthcare
Introductory Message from the Chairsystems and infrastructure, and Dr. Yamamoto has
been involved in developing human resources
related to medical care and management for thepast 10 years.
I had them in mind while planning this meeting, andI wanted to hear about their recent activities, so I
invited them. I am happy and excited for theopportunity to listen their lectures together with allof you.

Taro Kondo, MD, PhD
Managing Director, IMSJThis time, the theme of the meeting is the "Utilizationof ICT and AI in healthcare". We would like to think
about the future of healthcare.
In the first part, each person from London and Tokyo
will give a lecture. Since this is an online meeting,the audience can participate and view the lecturesfrom anywhere, and even those who are currently
active overseas can participate as presenters.
In Lecture I, Yosuke Takasaki, who is a medical
doctor and President of the Institute for SustainableSociety (ISS), will give a talk titled "Health-techinnovation for making our healthcare and societysustainable".
In Lecture II, Yuji Yamamoto, who is a medical
doctor and CEO of MinaCare Co., Ltd. will give atalk titled " Value-based healthcare and its strategies". Dr. Takasaki has been actively involved in building

LectureⅠ
Health-tech innovation for making our
healthcare and society sustainableYohsuke Takasaki, MD, PhD, ScM, MPA
President
Institute for Sustainable Society (ISS)Institute for Sustainable Society (ISS) connects thepassion and wisdom of front-runners in wide-ranged
areas related to sustainability and translates theminto concrete innovative actions to make our society inclusive, resilient, and sustainable for everyone
without boundaries. Based on those missions, the ISS
engages in projects for creating a sustainable society with a particular focus on the SDGs. The ISS’s value proposition is “Life,” a time to spend with loved
ones, a time to be moved by beautiful scenery, anda time to enjoy with your friends.

Page 7

The achievement of the SDGs has been jeopardized due to the COVID-19 pandemic. To overcome this formidable challenge, we need non-linear and non-contiguous evolution to accelerate
our efforts in a back-casting manner. We should not
let COVID-19 be just a tragedy; instead, we should
translate this pandemic into an opportunity to upgrade our society.
Meanwhile, population aging leads to increased
non-communicable diseases, or NCDs (e.g., diabetes, hypertension, cancer, etc.) and subsequent tremendous financial burdens. It is expected that Japanese total medical and long-term care expenditure would be doubled from 50T JPY in 2018 to 100T
JPY in 2040. Under such situation, we cannot handover our society to the next generation.
Innovation has helped our society be a betterplace. The ISS’s most important mission is R&D, including creating intellectual properties named“Formula of Life”; personalized AI is trained by individual data and can propose individually best-suited treatment empowered by behavioral economics technique, nowadays so-called a “deep tech.”Many social networking services, or SNSs, provide
highly addictive contents to stick users with personalized services based on their needs and preferences. Likewise, if we could collect individual health/
medical data and customize health-related advice
to maximize the effects, we can change users’ behaviors toward healthier ways. Thus, we are developing personalized AI modeling technology withindividual data generated from smartphones,
smartwatches, etc. For instance, the root causes of
NCDs are lifestyle, such as unhealthy diet, excess alcohol consumption, smoking, etc., which cannot
be directly modified by contemporary medicine orsurgery. These unhealthy habits come from our cognitive biases and tendencies. The latest evidenceshows that some cutting-edge behavioral economics techniques, like “nudge,” can alter these habits
unknowingly and effortlessly. We believe that personalized AI tailored by own individual data can effectively modify users’ behaviors into a healthierway.
Moreover, we are confident that our personalized
AI has the potential to transform current medical
science and practice completely. Conventional
medical science, i.e., randomized control trials, co-International Medical News

hort studies, etc., needs to rely on mass data consisting of anonymized individual data. Handling personal data in such science is technically tricky, suchas data gathering and analytics. Moreover, researches using mass data have a theoretical limitation: mass data cannot give us an individual effectspecifically, which is called ATE: Average Treatment
Effect of Rubin Causal Model (RCM). However,analysis of time-series personal data can demonstrate causal inference, namely ITE (Individual Treatment Effect). The individual causal inference will tell
us about the most suitable treatment and the best
health advice. In fact, a similar concept is alreadyavailable in cancer treatment, which is individual
cancer genome sequence is used to determine thecorresponding anticancer drug, a.k.a. “PrecisionMedicine.” Our approach is to ‘nudge’ people toward a healthier way and propose the most effective and suitable treatment depending on the patients’ condition by AI-maximized personalized information. We name them “Precision Health,” “Super Precision Medicine,” and “Information as aMedicine (IaaM),” respectively.
This new AI modeling with individual cognitive andphysical reactions will be a game-changer. Röntgen, who invented X-ray imaging, refused to takeout its patents, as he wanted society as a whole tobenefit from it. Our “Formula of Life (PersonalizedAI)” could be used as a fundamental methodology
to promote open innovation and achieve the SDGs.
“Formula of Life” is, so to speak, 21 century’s X-ray.
The world will become older and older without exception, which means the world will suffer from
more NCDs. We hope to safeguard the future by“Formula of Life,” believing it is “our responsibility”
that we keep our society sustainable and resilientfor the next generation.

Page 8International Medical News

LectureⅡ
Value-based healthcare and its strategies
Yuji Yamamoto, MD, MBA
Founder and CEO
MinaCare Co., Ltd.
The knowledge and technology of health care areevolving day by day, and now that we are in theage of 100 years, the expectations and demands ofsociety for health care are diversifying. Under suchpressure, medical care continues to change accordingly. For example, the place of medical carehas expanded from advanced medical institutions
to clinics, homes, and even into daily life. In addition, the medical evidence has increased from being based on clinical experience to being able tograsp the etiology more accurately. Furthermore,
the medical care model has changed from a patternistic one-to-one relationship between professionals and patients at medical institutions to medical care that is tackled by the community, regardless of whether or not care givers have professional
license. Health and productivity management promoted by the government is also supporting thistransition.
In this way, clinical practice is being pulled by theseemingly contradictory forces of technological sophistication and complexity and the fusion of services into daily life. However, it has been pointed
out that the evolution of the health care system andthe organization of the provider has not caught up
with these changes on the field side. It is pointed outthat the already complex medical field makes it
even more difficult to solve the problem because
the medical care provision system and the medical
fee framework are not evolving at a sufficient pace.
In business administration theory, the realization ofinnovation involves three elements: technology forsimplifying things, a business model that makes services affordable and accessible, and the industrial
infrastructure on which that business model is established. The theory requires them to be consistent.
Based on this, it can be said that in order to connect
new knowledge and technology to health care innovation, it is necessary to evolve the health carebusiness model and industrial base as well. The business model of health care is, for example, the ideal

way of medical institutions (arrangement of clinicaldepartments, design of care services, etc.), and theindustrial base is, for example, health insurance andmedical fee system.
In the current health care system in Japan, in principle, insured medical care, which occupies the mainpart, is provided by a professional at a medical institution after the onset of illness. And the fee is to bepaid accordingly. However, in view of the evolutionof health care knowledge and technology, and theexpectations and demands of society, I think that
health care can play its role even before it becomesa disease and in an environment not limited tomedical institutions. We have named this conceptof health care as "investment-type medical care"because it aims to invest in health rather than dealing with illness, and have promoted this concept asa widespread business. This business is now expanding health care to become more "care-giving" oneby utilizing data and ICT.
In this lecture, I will introduce the theoretical background of "investment-type medical care", its examples, and our achievements.

Discourse
Introduction of the speaker of discourse
Taro Kondo, MD, PhD
Managing Director, IMSJ
Norishige Morimoto, IBM Japan Vice President andChief Technology Officer, IBM Research & Development - Japan, will give a lecture titled "The Future ofComputing". He will talk about the future aspects ofquantum computers.

Discourse: The future of computing
Norishige Morimoto
Vice President and Chief Technology Officer
IBM Research & Development - Japan
Technology often evolves by reflecting the world’s
expectation and excitement. When people witness
the new technology, they will be inspired and start
to think of its possibility and its potential. Such a positive reaction will become the driving force for theadvancement of the technology.

Page 9In February 2011, IBM “Watson” played at the quizshow “Jeopardy!” and dramatically overperformed
two human quiz champions to surprise the world.
The event became a wakeup call to scientists whowere working on the Artificial Intelligent. It showed
the world what machine-based AI could do andnow it is “ready to play”. But AI has been studied
since early ‘60s, and what make it so special thistime? There were several key technology elements
which became available in the right place, at theright time.
The first is the computer systems. IBM has been leading the development of semi-conductor based CPU
chip for several decades, which the pace of theperformance to price growth twice in every 18months. The performance improvement of the chip
was mainly driven by the shrinkage of the transistor
and circuits on the chip. In 2011, we could have afully dedicated high-performance computer server
called Power7, with equipped with 2880cores ofCPU that was approximately 1million times more
powerful than what it was available in the ‘80s.
The second is the availability of high-quality digital
data. By the time the “Watson” plays Jeopardy!, thecollected human knowledge saved in the online
encyclopedia “Wikipedia” had reached to 5million
articles. This easily exceeds what human’s biological brain could possibly take. In addition, we could
add all kinds of record book such as sports almanac, song lyrics, news articles, novels and more text
base information to the database to train “Watson”
system. This kind of high-quality digital data were
not available before we have internet since 1994.
As this trend grows, we are now aiming to build
even more complex and smarter AI systems, withpeta bytes of data and exponentially growing complex knowledge network connected to each other.
That means, it will take exponential scale of computing power to do all the required work, which weknow we could not achieve with the current paceof growth in the traditional semi-conductor basesystem.
Quantum computer is a totally new concept ofcomputer based on quantum mechanics andquantum effects such as superposition and entanglement. Instead of classical mean of bit, it employsa special computing unit called quantum bit or qubit. The combination of qubits makes quantum

International Medical News

gates, to formulate quantum algorithms. This newconcept of computer will enable extraordinary
scale of computing that were not possible on its
classical counterpart, and provide a new way ofmathematical expression for the computing thatwas not easy or even possible until now.
IBM started the research of quantum computer
since early 70s, and started to build quantum computer since mid 2010s. The first quantum computerfrom IBM was released on the cloud in 2016, to encourage scientists from the world to use it and provide feedback to make it even better. Since then,IBM built more than 30 quantum computers andgathered more than 140 company and university research partners to drive this new field of technology.
In Japan, we started an industry-academia collaboration in 2018 called IBM Q Hub at Keio. It started
with collaboration between IBM, Keio University andfour industry member companies with half dozen ofscientists. Today, it grew into seven industry member
companies with more than 30 scientists, which became one of the most successful quantum application research groups within IBM Quantum Network.
In 2020, with University of Tokyo leading the pack,
we established Quantum Innovation Initiative Consortium (QIIC) with over ten industry partners, andplanning to open the first commercial quantum
computer data center (IBM Q System One) in Asia
Pacific (Shin-Kawasaki city) later this year.
In this talk, I will introduce the foundation of quantum computer and its structure, as well as the latest
update of our research activity and its future direction.